What Caused the Increase in Safety Rating for UConn’s Dempsey Hospital?

For the first time in four years, the University of Connecticut’s John Dempsey Hospital has earned an A rating on the Hospital Safety Scorecard, an evaluation of patient risks stemming from hospital errors.

The hospital showed a strong improvement over the past four ratings, which began at a C in 2012, rose to a B in 2014 and now, in 2015, has achieved the top grade.

Based in Farmington, Connecticut, the university hospital is part of the larger formation of UConn Health, a medical center that includes the UConn School of Medicine and the School of Dental Medicine, according to its website.

The Hospital Safety Scorecard, an evaluation created by a non-profit organization, the Leapfrog Group, that focuses on increased transparency in healthcare. The scorecard evaluates categories like safety problems with surgery, hospital-borne infections and correct staffing.

The group uses publically available data and additional information from a voluntary survey to evaluate the hospitals. Its goal is to give patients a way to find the safest hospitals in their community, according to the scorecard.

“UConn Health is very proud of [the staff’s] hard work,” in achieving a A rating, said Anne Diamond, chief executive officer of the hospital, in a press release.

“We thank our hospital’s faculty, nurses, and staff for their excellent clinical care and commitment to always putting patients first and helping to improve the patient experience,” she said.

The Hospital Safety Scorecard addresses an underpublicized issue in health care, according to Leah Binder, president and CEO of the Leapfrog Group, the company behind the Hospital Safety Scorecard.

One in every six hospital patients endures adverse effects from their treatment and between 200,000 to 400,000 patients in the U.S. die every year from these avoidable errors, she said.

According to Binder, these effects can be life threatening, and often stem from small, preventable errors.

“Simple mistakes that can be made in the routine course of business in a hospital can have catastrophic consequences for patients and their families, so it really is important for health systems to operate in a way that really respects the meaning of their work to their own patients,” Binder said.

Binder learned the hard way that small mistakes can put a life at risk when she almost lost her 3-week-old son to mistreatment and medical errors, she said. Luckily, today he is a healthy, 6 foot 1, 17-year-old, but it left Binder with a mission.

“We do the hospital safety score and the Leapfrog ratings for ourselves, as well as for the public at large. For me, and I think for most Americans, safety comes first,” Binder said.

Since its C rating in 2012, Dempsey has steadily worked toward better patient safety, said hospital officials. It’s the hospital’s “number one priority,” Diamond said.

According to Binder, the strong improvements across various categories in the 2015 scorecard show that to be true.

“None of our A [rated] hospitals are by any means perfectly safe, including this one, and we always say you have to be vigilant when you go in a hospital, no matter an A or an F, but I just look at these numbers and I see real leadership behind [them] to change this,” Binder said.

In the fall 2013 scorecard, Dempsey’s scores were furthest below average in four categories: “care of the ventilated patient,” “CAUTI” or Catheter-Associated Urinary Tract Infection, “collapsed lung due to medical treatment” and “accidental cuts or tears from medical treatment.”

In all of these categories, Dempsey ranked between the zero and eighth percentile–that’s to say 92 percent to 100 percent of the other hospitals evaluated by the Hospital Safety Scorecard in 2013 performed better than Dempsey.

In fall of 2015, the scorecard showed vast improvement in each of these categories for Dempsey.

“It’s clearly been a real, all-out effort in that hospital to get some improvement and they’ve shown it, so they did earn that A,” Binder said.

In “care of the ventilated patient,” a category that checks for proper cleaning of ventilators before and after use on patients, Dempsey now ranks in the 65th percentile, meaning it’s on-par with or more effective than 65 percent of the other hospitals evaluated for ventilator care.

Dempsey also increased its rating for catheter-associated UTIs (“CAUTI”) to above average.

This category, called “Infection in the urinary tract during ICU stay” on the website, monitors staff use of urinary catheters, devices that can cause infection and death if used not cleaned or removed correctly, according to the scorecard. Dempsey now ranks in the 62nd percentile for patients developing catheter-associated UTIs.

While the hospital continued to improve under “collapsed lung due to medical treatment,” a category that documents collapsed lungs after procedures, it didn’t reach the average level of other hospitals evaluated.

It now ranks in the 34th percentile, meaning 66 percent of hospitals scored the same or better.

The last category that Dempsey scored lowest on in 2012, accidentally cutting a patient during surgery, increased from below average to average. The hospital currently stands in the 40th percentile.

While its improvements from 2013 earned the hospital its A rating, it still has work to do.

In the category of serious breathing problems after surgery, for example, the hospital fell from a ranking in the 81st percentile in 2013 to the 39th percentile in 2015.

This is one of five categories on the current scorecard in which the hospital ranks below average. There are 28 categories total.

All of the below-average ratings for the hospital are related to surgeries, be it preparatory procedures, operations or post-surgery procedures.

According to Lauren Woods, health information officer for UConn, Dempsey conducted almost 11,000 surgeries in the 2015 fiscal year.

“We review the outcomes of all surgeries where outcomes are not as expected and work to improve areas identified. This has been a process that has helped us improve in other areas and it is very effective,” Woods said.

Errors are expected, said Binder, but the goal is awareness and improvement.

“Every hospital is staffed by human beings so of course they make errors, we expect them to make errors, my only question is, ‘Does the hospital have an infrastructure in place so that when an error is made, there’s a good chance it will be caught by someone else?’,” Binder said.

“That’s what you want, because the slightest error in a hospital can have extreme effects on patients,” she said.